When a patient undergoes a medical imaging exam, it is common for the reading physician to make measurements or create annotations using computerized reading systems, commonly called PACS (picture archive and communication systems). Tumors, vascular stenosis, organs, or other items may be measured using linear dimensions, area, density in Hounsfield units, optical density, standard uptake value (for positron emission tomography), volume, curved lines (such as the length of a curved vessel), stenosis (percent narrowing of a vessel at a certain location relative to a reference location), or other parameters. In addition, annotations may include arrows to indicate specific locations or anatomy, circles, polygons, irregularly shaped areas, etc.